Individual provider Active NPI

Caidin Thomas Smith, LCSW, LMSW

  • Clinical Social Worker
  • Delray Beach, FL
National Provider Identifier
1053038786
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW23315 Issued in FL
Practice address
6586 Atlantic Ave # 136
Delray Beach, FL 33446-1617
Phone
(203) 240-0426
NPI assigned
Oct 24, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Clinical Social Worker 1041C0700X SW23315 FL Primary

Addresses

Primary practice location

6586 Atlantic Ave # 136
Delray Beach, FL 33446-1617

Mailing address

6586 Atlantic Ave # 136
Delray Beach, FL 33446-1617
Phone (203) 240-0426

Other practice location 1

111 New Haven Ave
Derby, CT 06418-2197
Phone (475) 439-9639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW23315FLMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1053038786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6586 ATLANTIC AVE # 136",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334461617",
            "telephone_number": "203-240-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6586 ATLANTIC AVE # 136",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334461617",
            "telephone_number": "203-240-0426"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 New Haven Ave",
            "address_purpose": "LOCATION",
            "city": "Derby",
            "state": "CT",
            "postal_code": "064182197",
            "country_code": "US",
            "telephone_number": "475-439-9639",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITH",
        "first_name": "CAIDIN",
        "middle_name": "THOMAS",
        "credential": "LCSW, LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.